By Madhavi Challagulla, M.D.
Internal Medicine in Wilmington, MA
High blood pressure is known as “the silent killer” because the condition has no symptoms.
About one out of every three adults in the United States has high blood pressure, also known as hypertension. That’s about 70 million people nationwide. A 2011 study by the Massachusetts Partnership for Health Promotion and Chronic Disease Prevention found nearly 30 percent of adults in our state have been told at some point that they have high blood pressure.
Even more frightening? Only a little more than half of the people with high blood pressure have it under control, and many don’t even know they have it.
We often call high blood pressure “the silent killer” because, unlike some other medical problems, high blood pressure has no symptoms. Yet this condition is a major risk factor for heart disease, stroke, and many other life-threatening problems.
But there is good news! You can lower your blood pressure through dietary changes, a healthy exercise program, and medication, if you need it. Let’s go over what I share with my patients who need help controlling their hypertension, starting with the basics.
What is high blood pressure?
Your blood pressure measurement consists of two numbers:
- Systolic pressure: The top number, which represents the pressure in your arteries when your heart beats.
- Diastolic pressure: The bottom number, which represents the pressure in your arteries between heartbeats.
We measure blood pressure in millimeters of mercury, or “mm Hg” for short. A normal systolic blood pressure reading should be less than 120 mm Hg, and a normal diastolic blood pressure reading should be less than 80 mm Hg. If your blood pressure is above these normal readings, you could have or be at risk for high blood pressure.
Who is at risk for high blood pressure?
The most common type of high blood pressure is called essential hypertension. While we do not understand the exact mechanisms, we do know there are many risk factors that contribute to development of high blood pressure, including:
- Genetic predisposition
- Diet with too much salty or fatty food
- Being overweight or obese – more than two-thirds of American adults are either overweight or obese.
- Excessive alcohol intake
- Family history of high blood pressure
- Lack of exercise
- African-American ethnicity
- Age (risk increases as we age)
How can you lower your blood pressure?
Keeping your blood pressure in the normal range is important. If your blood pressure is too high, work with your doctor to lower it through a number of approaches.
One of the first things I advise my patients to do is lose weight. Maintaining a healthy diet is a key factor in weight loss. The DASH (Dietary Approaches to Stop Hypertension) diet is a common-sense plan you can follow to reduce the risk for hypertension.
Here are a few things I recommend to my patients who need help losing weight:
- Eat smaller portions
- Choose lean meat more often than red meat
- Eat more nuts, legumes, and whole grains
- Opt for low-fat dairy instead of full-fat
- Eat more fruits and vegetables
- Lower sodium intake (not just salt added while cooking – there is a lot of hidden salt in foods such bread, canned foods, salted meats, etc. Be sure to read food labels.)
The DASH diet is based on 2,000 calories per day. The number of calories you need to maintain your weight varies depending on your age, gender, and activity levels. A good rule of thumb I tell my patients is: If you’re trying to lose weight, reduce your calorie intake by about 500 calories a day. If you cut 500 calories per day for seven days, you can lose about a pound per week. But this result is not set in stone. Your metabolism, age, and starting weight influence how many calories you need and how fast you’ll lose weight. Your doctor can help you with a dietary plan that’s specific to your needs.
Regular exercise also is important. I tell my patients they should get about 30 minutes of exercise a day five or six times a week. This doesn’t have to be high-intensity exercise — it could be a brisk walk for 30 minutes. What matters is that you are active during that time.
If diet and exercise aren’t enough, you might need medication to reduce your blood pressure to a safe level. There are different classes of blood-pressure medication available. Your doctor can work with you to find a medication that’s right for you based on your age, ethnicity, allergies, and any other considerations.
Avoid the “silent killer” of high blood pressure
When my patients start on their blood-pressure-control measures, one of the first things they ask is, “How often do I have to come and see you?” I know going to the doctor isn’t on anyone’s list of favorite activities, but you may need to see your doctor fairly often, at least at first, to get your blood pressure under control. Once your blood pressure is controlled, you probably won’t have to visit your doctor as often.
Because obesity is a risk factor, more and more people are at risk for high blood pressure. And it’s not just adults who need to be mindful. About one-third of American kids and teens age 6 to 19 are overweight or obese.
The best way to address high blood pressure is to avoid developing it — and that means not waiting until late adulthood to start thinking about it. Parents need to help their kids make healthy choices. Teach your children by example to reduce their risk for high blood pressure and other health problems later in life. See your physician at least once a year after age 35 to get screened for hypertension, and earlier if you are overweight and have significant family history of high pressure.
If you have high blood pressure, or if you may be at risk, schedule an appointment with your doctor to discuss what you can do now to treat this “silent killer” before it strikes.
Tags: family health, geriatrics, high blood pressure, women's health